OAR 333-046-0120: Clinic Appeals

(1) A clinic may appeal an Oregon Health Authority (Authority) decision in which the clinic is directly adversely affected such as the following: (a) A denial of an application for new or continued participation in the Vaccines for Children (VFC) program or Vaccine Access Program (VAP). (b) Sanctions imposed, or intended to be imposed, by the Authority on a clinic. (2) A clinic appeal is initiated by filing a timely request in writing for review by the Authority. (3) A clinic’s appeal request is not required to follow a specific format as long as it provides a clear written rationale from a clinic expressing disagreement with the Authority’s decision. (4) The request must identify the decision made by the Authority that is being appealed and the reason the clinic disagrees with that decision. (5) A clinic’s appeal request is timely if it is received within 60 calendar days of the date of the appealed decision. (6) In the event a clinic’s request for appeal is not timely, the Authority shall determine whether the failure to file the request was caused by circumstances beyond the control of the clinic. In determining whether to accept a late appeal, the Authority requires the request to be supported by a written statement that explains why the request for review is late. In determining timeliness of filing a request for review, the amount of time the Authority determines accounts for circumstances beyond the control of the prescriber is not counted. (7) The burden of presenting evidence to support a clinic’s appeal is on the clinic. (8) Agency appeal proceedings, if any, shall be held in Portland, unless otherwise stipulated to by all parties and agreed to by the Authority.